May is Stroke Awareness Month, and for many of us, the illness is seen as a consequence of vascular wear and tear, and usually of old age. That is a misconception that can be fatal for unsuspecting and often younger sufferers. It’s important to be aware of the warning signs and risks—even if you are young and healthy—of this devastating medical event.
Vanessa Perez, 35, of Plantation, first experienced something strange on Veterans Day last year. Her hands were tingling, and that tingling expanded to her entire left side of the body by the evening. The next morning, Perez continued to feel unwell, and she started to experience balance issues. After dropping off her 3-year-old daughter, she went to an urgent care clinic. They checked her vitals, which were OK, but couldn’t rule out a stroke because they don’t have the equipment.
After still not feeling well despite some resting, Perez decided to go to the emergency room (ER). Initially, she had difficulties convincing ER staff that something serious was happening. A CT scan didn’t yield anything concrete, and finally an MRI was ordered. While waiting for the MRI results, Perez tried to walk to the bathroom, but had difficulties. Luckily, that’s when the MRI results came back, and doctors realized she was suffering a dangerous stroke. She was immediately admitted into the ICU.
After transferring to another hospital with a stroke specialist unit, the doctors were able to stabilize her, and they confirmed she had cavernoma, a condition that can cause strokes. Cerebral cavernous malformations (CCMs), also known as cavernomas, are clusters of abnormal capillaries lacking intervening brain tissue. They can be asymptomatic, or they can cause seizures, headaches, and/or strokes. CCMs can be sporadic, or in 20% of cases, they have a familial inheritance pattern.
While strokes still mostly affect the elderly, who often have more cardiovascular risks, there is an alarming trend of rising incidents of stroke among younger adults, those under age 45. In a recent study by Dr. Aaron Shoskes, a neurologist from the University of Utah, his team found that strokes in younger adults have been rising in recent years. Researchers reported a rise of as high as 15.7% for adults in the 18–44 and 45–64 age brackets.
There are a myriad of factors being examined as possible contributors to this increase. Traditional cardiovascular risk factors—high blood pressure, diabetes, high cholesterol, obesity, and smoking history—are increasingly found more common in the younger population, according to Dr. Shoskes. Caffeine, vaping, energy drinks, and ADHD meds have also contributed to increased risks. These stimulants spike your blood pressure and/or affect your heart rhythms, which may add to your overall risk of stroke.
For younger adults, women are found to be more likely to suffer from strokes than men, whereas the opposite is true for those over 45. One American Heart Association study hypothesized that estrogen helps protect women from cardiovascular events, but it increases risks for strokes.
For Perez, her stroke was in the brain stem area, affecting almost everything, including her balance, breathing, and vision. When she finally left the hospital, she still had a long road to recovery, like many stroke patients. Her daughter was disappointed she couldn’t play with her mom, but according to Perez, otherwise she handled the situation well. Perez started physical and occupational therapy, and she was initially feeling overwhelmed. Luckily for her, she had a good support system of friends and family to help her through those difficult early recovery stages.
After five months of recovery, Perez was finally able to go back to work. Her advice: If you are not feeling well, go to the hospital. For stroke victims, the speed of diagnosis and treatment has a profound link to the prognosis. Stroke symptoms are often dismissed as stress, migraine, or even a hangover. Delayed medical treatment significantly increases the damage that a stroke does to your brain.
Some of the symptoms to look for:
- One side of face drooping, or one side of body numb/tingling
- Sudden, severe headache, often described as “worst headache of my life”
- Loss of balance or coordination, dizziness, trouble walking
- Blurred or double vision, loss of sight in one or both eyes
- Confusion, difficulty understanding speech, disorientation
Stroke symptoms almost always appear suddenly, and even if they seem to resolve quickly (a transient ischemic attack or TIA, often called “mini-stroke”), they require emergency medical attention. The damage to brain tissue is time-sensitive, and every minute matters to reduce the greater risk of permanent brain damage.
Prevention is also important, as many of the risk factors are silent. Because many young adults feel healthy, and may not have a primary care physician, their risk factors go unnoticed. A routine checkup can reveal some important risk factors:
- Blood pressure
- Blood sugar
- Cholesterol
- Weight
- Family history of strokes
Early awareness of these risk factors can help a clinician provide a management plan.
The face of stroke is not just the elderly. Stress, high-powered energy drinks, and underlying health risks all contribute to a yet incomplete picture of why younger adults are having more strokes. Regardless of the causes, it is now equally important for those who otherwise feel healthy to be aware of stroke symptoms and risk factors, and to have a discussion with their family doctor. When you are experiencing stroke symptoms, don’t hesitate, and go to the emergency room—it may save your life.